Meaningful Use

What is Meaningful Use?

The Meaningful Use (MU) Incentive Program is a federal initiative that encourages eligible professionals (EPs) and hospitals to adopt, implement, upgrade, and meaningfully use certified electronic health record (EHR) technology. The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) administer the MU Incentive Program.

The MU Incentive Program has three stages. Eligible professionals and hospitals can receive incentive payments for demonstrating MU of certified EHR technology in each stage.

Stage 1 of MU requires EPs and hospitals to use certified EHR technology to capture and report on clinical data. Stage 1 focuses on the use of EHRs to improve quality, safety, and efficiency.

Stage 2 of MU requires EPs and hospitals to use certified EHR technology to capture and report on more clinical data. Stage 2 focuses on the use of EHRs to improve patient engagement and care coordination.

Stage 3 of MU requires EPs and hospitals to use certified EHR technology to capture and report on even more clinical data. Stage 3 focuses on the use of EHRs to improve outcomes.

To receive an incentive payment, EPs and hospitals must meet certain requirements for each stage of MU. For Stage 1, EPs and hospitals must meet certain requirements for using certified EHR technology to capture and report on clinical data. For Stage 2, EPs and hospitals must meet certain requirements for using certified EHR technology to capture and report on more clinical data, as well as using that data to engage patients and coordinate care. For Stage 3, EPs and hospitals must meet certain requirements for using certified EHR technology to capture and report on even more clinical data, as well as using that data to improve outcomes.

The MU Incentive Program is a voluntary program. EPs and hospitals can choose to participate in any or all stages of MU. However, to receive an incentive payment, EPs and hospitals must demonstrate MU of certified EHR technology.

The MU Incentive Program is scheduled to end on December 31, 2021. After that date, EPs and hospitals will no longer be eligible to receive incentive payments for demonstrating MU of certified EHR technology.

How can I ensure that I am meeting the requirements for Meaningful Use?

The Centers for Medicare & Medicaid Services (CMS) has established a set of criteria, called “Meaningful Use,” that eligible professionals (EPs) and hospitals must meet in order to qualify for incentive payments under the American Recovery and Reinvestment Act (ARRA). In order to receive an incentive payment, EPs and hospitals must demonstrate that they are “meaningfully using” certified electronic health record (EHR) technology in a way that improves patient care.

The Meaningful Use criteria are divided into three stages, with different requirements in each stage. Stage 1 focuses on the use of EHRs to capture and share data. Stage 2 focuses on the use of EHRs to improve clinical care. Stage 3 focuses on the use of EHRs to improve population health.

To receive an incentive payment, EPs and hospitals must meet all of the requirements in a given stage. For example, to receive an incentive payment for Stage 1, an EP or hospital must meet all of the Stage 1 requirements.

The Meaningful Use criteria are designed to encourage EPs and hospitals to use EHRs in ways that will improve patient care. However, meeting the Meaningful Use criteria is not always easy. In some cases, it may require a significant investment of time and resources.

The good news is that there are many resources available to help EPs and hospitals meet the Meaningful Use criteria. CMS has developed a number of resources, including an online tutorial, to help EPs and hospitals understand the Meaningful Use criteria. In addition, CMS has contracted with a number of organizations to provide technical assistance to EPs and hospitals.

The bottom line is that meeting the Meaningful Use criteria is important, but it is not always easy. There are many resources available to help EPs and hospitals meet the criteria. With a little effort, EPs and hospitals can find the help they need to successfully meet the Meaningful Use criteria.

What are the requirements for Meaningful Use?

The Centers for Medicare & Medicaid Services (CMS) has established a set of core and menu objectives that eligible providers must meet in order to qualify for Meaningful Use incentives under the Medicare and Medicaid EHR Incentive Programs.

The objectives are designed to ensure that eligible providers who adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology:

1. Improve quality, safety, efficiency, and reduce health disparities;
2. Engage patients and families in their health care;
3. Improve care coordination;
4. Improve population and public health; and
5. Ensure adequate privacy and security protections for personal health information.

To receive an incentive payment, eligible providers must meet all of the objectives for the applicable stage of meaningful use. In addition, eligible providers must submit information on all of the clinical quality measures (CQMs) selected for their reporting period.

The table below lists the core and menu objectives for each stage of meaningful use. Eligible providers must meet all of the core objectives for a given stage. In addition, they must select and meet 5 of the 10 menu objectives.

Stage 1 Core Objectives

1. Use computerized provider order entry for medication, laboratory, and radiology orders;
2. Implement one clinical decision support rule;
3. Record demographics, chief complaint, and history of present illness;
4. Record and chart changes in vital signs, as well as growth measurements for children;
5. Record smoking status for patients 13 years or older;
6. Incorporate clinical lab test results into EHR as structured data;
7. Generate and transmit permissible prescriptions electronically (eRx);
8. Provide patients with an electronic copy of their health information, upon request;
9. Provide clinical summaries for patients for each office visit;
10. Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results) among providers of care and patient authorized entities electronically.

Stage 1 Menu Objectives

1. Medication reconciliation – The provider compares the patient’s medication list to the medications that are ordered and documents any discrepancies;
2. Patient-specific education resources – The provider identifies patient-specific education resources and provides those resources to the patient;
3. Immunization registry reporting – The provider reports immunization data to immunization registries or immunization information systems;
4. Syndromic surveillance reporting – The provider electronically reports syndromic surveillance data to public health agencies;
5. Electronic reporting of quality measures – The provider electronically reports quality measures to CMS or a state;
6. Electronic prescriptions – The provider generates and transmits permissible prescriptions electronically;
7. Public health reporting – The provider electronically reports public health data to public health agencies;
8. Clinical information reconciliation – The provider reconciles the key clinical information for a patient from all sources of care;
9. Patient health information exchange – The provider electronically exchanges key clinical information among providers of care and patient authorized entities; and
10. Electronic access to health information by patients – The provider provides patients with electronic access to their health information.

Stage 2 Core Objectives

1. CPOE for medication, laboratory, and radiology orders;
2. Implement one clinical decision support rule;
3. Incorporate clinical lab test results into EHR as structured data;
4. Generate and transmit permissible prescriptions electronically (eRx);
5. Provide patients with an electronic copy of their health information, upon request;
6. Provide clinical summaries for patients for each office visit;
7. Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results) among providers of care and patient authorized entities electronically.

Stage 2 Menu Objectives

1. 1. Medication reconciliation – The provider compares the patient’s medication list to the medications that are ordered and documents any discrepancies;
2. Patient-specific education resources – The provider identifies patient-specific education resources and provides those resources to the patient;
3. Immunization registry reporting – The provider reports immunization data to immunization registries or immunization information systems;
4. Syndromic surveillance reporting – The provider electronically reports syndromic surveillance data to public health agencies;
5. Electronic reporting of quality measures – The provider electronically reports quality measures to CMS or a state;
6. Electronic prescriptions – The provider generates and transmits permissible prescriptions electronically;
7. Public health reporting – The provider electronically reports public health data to public health agencies;
8. Clinical information reconciliation – The provider reconciles the key clinical information for a patient from all sources of care;
9. Patient health information exchange – The provider electronically exchanges key clinical information among providers of care and patient authorized